Improving Quality and Safety in the Endoscopy Unit (Virtual) | November 2025-Defining and Measuring Quality in ERCP and EUS

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This presentation by Dr. Jessica Yu from Oregon Health and Science University addresses defining and measuring quality in Endoscopic Retrograde Cholangiopancreatography (ERCP) and Endoscopic Ultrasound (EUS). High-quality procedures depend on correct indication, proper diagnoses, appropriate therapy, and risk minimization through cognitive and technical expertise.<br /><br />Quality indicators serve as standardized, evidence-based metrics to monitor and improve performance, divided into pre-, intra-, and post-procedure measures, including outcomes and processes, with targets such as a 98% "never event" rate. Common quality indicators apply across all endoscopy procedures.<br /><br />Key principles for high-quality ERCP/EUS include the right indication, patient selection (considering cardiopulmonary risk and contraindications), a trained multidisciplinary team, appropriate equipment, well-established protocols throughout care phases, and effective communication with the medical team, patient, and family.<br /><br />For EUS, quality indicators encompass verifying appropriate indications, obtaining detailed informed consent with risk stratification and alternatives discussion, and appropriate use of prophylactic antibiotics. Intraprocedural quality focuses on therapeutic interventions and minimizing adverse events.<br /><br />ERCP-specific quality metrics require careful patient selection, knowledge to prevent complications like post-ERCP pancreatitis, mastery of tools and rescue strategies, and using equipment suited to procedural complexity. Post-procedure efforts include clear documentation, measuring outcomes, feedback, and optimizing factors affecting success. Awareness of procedure difficulty grades is essential to know limits.<br /><br />Overall, quality in ERCP and EUS relies on consistent cognitive and technical skills executed by a competent team, matching techniques and tools to procedural complexity. Measuring quality metrics regularly and fostering a culture of quality and safety, championed by dedicated leaders, are crucial to achieving optimal patient outcomes in therapeutic endoscopy.

Asset Subtitle

Jessica X. Yu, MD, MS

Keywords

ERCP quality indicators

EUS quality measurement

endoscopic retrograde cholangiopancreatography

endoscopic ultrasound

procedure risk minimization

therapeutic endoscopy standards

post-ERCP pancreatitis prevention

multidisciplinary endoscopy team

quality metrics in endoscopy

patient selection criteria